One for Veterinary Assistants: What to Do About Customers Who Can’t Afford the Vet Bill (Video)

Janice is coming into the final week of her pregnancy, and I can’t begin to tell you how excited I am about the impending arrival of the puppies! A couple of days ago, I took her to see Dr. Stephen and the rest of her friends at the animal hospital, and she had an ultrasound done. Everything looks good, and it would seem that I can expect a large litter; she’s going to have nine! Stephen says everything looks good, and I shouldn’t have to worry about complications.

Of course, a lot of people don’t bother with ultrasounds. There’s pretty much no such thing as an inexpensive veterinary procedure, and ultrasounds aren’t the exception that proves the rule. The thing is, though, I’ll do without a lot to make sure that Janice gets the best possible care. The last thing I want is unpleasant surprises at this stage of the game, or when she’s actually whelping. So my take on it is that I don’t put a price on her health.

I’m also very fortunate in that the writing thing is working out pretty well for me, and I don’t have to worry about not being able to pay or an enhanced level of care. There have been times, though, when life wasn’t quite so good, and I told you a bit about those times in How to Keep a Dog When You’re On a Tight Budget. To put it simply, I was using the Internet at the local library, and Googling things like “Do ramen noodles contain vitamins?” and “Can I pull my own wisdom teeth?”

I didn’t have a dog back then, simply because I couldn’t afford one.

Back to the Point

Sorry about that! You’re wondering, “What in the world is Ash leading up to here?” Well, you know I do have a tendency to digress. So, back to the point.

While I was at the clinic with Janice, one of my favorite vet assistants, Dean, mentioned that he really liked the post I wrote entitled, Veterinarians, Vet Techs and Job Burnout. He said that he was a regular reader, and would like to see more posts that have to do with what actually goes on in animal hospitals and how staff is affected.

Well, I thought for a minute or two, and I realized that Dean was right. I’m always blogging about issues that relate to dogs and dog owners, but I don’t typically take a look at things from the “other side” of the equation.

I asked Dean what his main issue is when it comes to dealing with dog owners, and he said that other than burnout, which was the topic of the post he liked, it’s people who say they can’t afford the vet bill. Sometimes, he told me, it’s not really that they can’t afford it, it’s just that they want to nickel and dime the clinic, try to negotiate a better rate, or somehow think that dogs should be low- or no-maintenance.

So, I talked with Dean for a bit, and promised him that I’d do a post about people who can’t afford the vet bill, or say they can’t, and what veterinary assistants can do when confronted with those customers.

Times are Tough All Over

I think it’s a safe bet that no one ever has as much money as they’d like. Some people don’t even have as much money as they really need. I waited a long time, after I left my parents’ home, before I got my first Boxer, Gloria. I knew that I was in no position, early on, with my poverty-level call center job, to afford even the purchase price of a good dog, never mind the care that she would require, so I waited.

Now, things are good. But it’s still in the back of my mind that things could change in a heartbeat. What if I ended up in an accident and couldn’t work for awhile? What if I became ill and, again, couldn’t work? What if a natural disaster occurred and caused damage to my home that my insurance wouldn’t cover?

Well, I guess I could probably play “What If” all day. Sometimes, stuff happens that can have a huge impact on our financial resources. If I’m lucky, though, I figure that my personal level of comfort won’t change much, and it will be luxuries that I won’t be able to afford. I’ll just be saying, “A new car isn’t in the budget,” or “The dogs and I are going to have to forget about a vacation this year.” It won’t be something along the lines of, “My dog is sick and I can’t afford the vet bills.”

At least at this point in my life, I don’t have to insert my debit card into the card reader at the grocery store and pray that it doesn’t come up declined. And I can afford the little extras when it comes to veterinary care for my dogs – like Janice’s ultrasound.

How Tough Are They?

So, how tough are times right about now for a lot of people? Well, I don’t think it’s all that uncommon for a person to find themselves in the position of having to rely on credit for things like vehicle repairs. Or for veterinary care for their pets. As I said, circumstances can change quickly. And I can imagine how horribly embarrassing it must be to have to try to explain at the animal hospital that you can’t afford the vet bill.

It’s a whole different thing when it’s something like explaining to a friend, “Sorry, I can’t go clubbing with you tonight; I’m a bit over-extended right now.” And it’s not all that bad when, at work, you have to say, “No, I can’t contribute to [insert name of charity your coworker is shilling for] right now, but catch me next week. These things aren’t all that embarrassing.

But admitting that you can’t afford healthcare for this sweet creature that you have sworn to love and protect? That is embarrassing. It can also make you feel frustrated and angry. And then you’re dealing with the veterinary assistant, on the other side of the counter (you know, the side where the cash register is located), and they’re feeling embarrassed, as well.

So how do veterinary assistants handle these situations? How should they handle them?

Okay, Dean, this is for you. I don’t pretend to know everything (despite the fact that I have pointed out more than once in my writings that my sister, Colleen, calls me an FKIA, which I figure stands for “famous know it all”), but this is my take on what I’d do if I were on your side of the counter.

Don’t Judge

I know it drives you nuts when someone pulls up to the animal hospital in a fancy car, and then proceeds to complain about what you’re charging for treatment. You don’t know what’s going on in that person’s life. It could be that they’ve just lost their job, or a family member besides their dog is ill and they’re bleeding money paying for medical care. That Cadillac might be days away from being repossessed.

Also, bite your tongue when they say things like, “So, do I own shares in this clinic yet?” or, “Have I paid for the doctor’s vacation?” or, “Is that syringe gold-plated?” Just try to smile and carry on, because as I’ve just suggested, there could be things going on that you don’t know about.

Talk About Cost Up Front

Sometimes, people really are on a shoestring budget. So it’s best to avoid surprises. Explain to the client what procedures are vital and which are optional. Tell them about all the potential issues that might be discovered, and explain exactly how much each is going to cost. This will go a long way to avoiding having a client panic once the treatments are finished, saying, “I can’t pay this vet bill!”

You’re not always going to get it absolutely right, of course. But at least this way, the client will have some idea of what to expect.

Get a Deposit

This is especially important if you’re seeing a new client. The last thing you want is to end up in a situation where the dog owner goes into full-on panic mode and races out of the clinic without paying you anything. Most of the time, people that you know are going to clue you in if they’re in difficult financial circumstances and ask if you can come to some sort of arrangement regarding payment. Newbies could end up doing the veterinary clinic equivalent of a “gas and dash.”

So, collecting a deposit, particularly from new clients, can at least mitigate your losses.

Give an Update

This is something that you can do if the dog has to spend some time in the animal hospital – following surgery, for example. This is nothing more than a daily phone call (which you should do daily anyway, just to let the client now how his or her dog is making out). Try something along the lines of, “He slept most of the day, and seems to be doing really well. Oh, and just in case you were wondering, right now the total cost of care is X dollars and X cents.”

Be Up Front About Your Billing Policy

Some clinics will allow customers to pay in installments. Others require “cash on the dash” before they will even release the dog. Your customers have a right to know your billing policy, so tell them what that policy is even before you take the dog in for treatment.

At Stephen’s clinic, I can pay in installments if I want to. If I haven’t paid within 30 days, I get a “friendly reminder.” If I don’t pay within 60 days, I get another reminder along with an interest charge of 2% per annum. By the 90 day point, the reminder would be considerably less friendly, and the interest would be compounding. If I were to let it go to 120 days, my account would be handed off to a collection agency, and then if I ever wanted to have a dog treated at that clinic again, I would have to pay cash.

Now, keep in mind that there are always going to be some accounts that you’ll never collect. But if you’re up front about how you do your billing, and what the consequences will be for nonpayment, you’ll probably be able to weed out a lot of people. They’ll just say, “I can’t pay a vet bill right now” and go looking elsewhere to have their pet treated.

Put Someone in Charge of Accounts Receivable

Almost every business (and animal hospitals are no exception) can benefit from having a person who knows the billing policy inside and out, and is comfortable chasing down debt. It should also be someone who has a gentle manner but also a firm one when the “gentle” approach isn’t working.

Know When to Use a Collection Agency

Sometimes, accounts receivable get so old that you might have no choice other than to hand them off to a collection agency. Some will charge a flat rate. Others will want a percentage of what can be collected. Some may also want you to hand over so many accounts in a given period of time. If your accounts do end up going to collection, though, don’t hold out a whole lot of hope of recovering your money. Once in a while, someone will pay off the debt because they want to get approved for a credit card, or financing for a home or car, but most of the time, the money is just lost.

Hang Onto the Dog

I’m serious. If you want to get paid, and someone is saying “I can’t afford the vet bill,” keep the dog in the back.

I’m telling you this because I know what I would do if I were one of those “I can’t afford the vet bill” people, but my dog needed treatment. I wouldn’t do this for non-life-saving treatment, but if it was a matter of “I have no money and if my dog isn’t treated he will die,” then here’s what I’d do. And I’m not claiming to be right, or moral, or ethical here. I’m just saying “This is Ash.”

What I would do is bring my dog to your animal hospital, beg you to save his life, tell you that price is no object, and then, if I had no money, I would write you a rubber check. If you didn’t accept checks, I would simply grab my dog and run. Because his life would be so precious to me, I’d do anything to save it.

I’m sure I can’t be the only one.

The Final Word

So, Dean, stay cool and try to work with those idiots who really do have money and don’t want to spend it on their dog. Don’t make assumptions, though, that this is what you’re dealing with. Keep in mind, too, that it’s not always easy talking about money, but sometimes, it simply has to be done. If clients know up front what’s expected, then chances are you won’t have to deal with too many people who say, “I can’t pay the vet bill.”

If your clinic allows it, try to work out a reasonable payment plan with your clients who are in financial distress. Often, someone who can’t come up with a thousand dollars right out of the gate can, and will, give you $100 a month until the debt is paid off.

I really don’t think that any animal hospital wants to turn away a dog that needs treatment. Most of the time, there is room for flexibility. Just make sure that your clients know up front what’s required.